Key result
Multistate cohort evaluates sacubitril/valsartan versus ACEI/ARB across the ejection fraction spectrum.
Why the study?
Evidence for the efficacy of sacubitril/valsartan compared with ACEI/ARB at higher left ventricular ejection fractions is less definitive.
Cohort
Yes
Evaluates sacubitril/valsartan versus ACE inhibitors or ARBs in heart failure, highlighting varying treatment effects across left ventricular ejection fraction levels.
Angiotensin receptor/neprilysin inhibition with sacubitril/valsartan is an established therapy for heart failure (HF) with reduced ejection fraction, reducing cardiovascular death or HF hospitalization compared with enalapril in the PARADIGM-HF (Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) trial.1 Evidence at higher left ventricular ejection fractions (LVEF) is less definitive. The findings of the PARAGON-HF (Prospective Comparison of ARNI with ARB Global Outcomes in HF With Preserved Ejection Fraction) trial were neutral overall, although treatment effects favored patients below the trial median LVEF of 57% and women.
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Helou et al. (2026) conducted a cohort in Heart failure. Sacubitril/Valsartan vs. Angiotensin-Converting Enzyme Inhibitor/Angiotensin Receptor Blocker was evaluated. Sacubitril/valsartan versus ACEI/ARB across the ejection fraction spectrum in a multistate real-world cohort was discussed, but the abstract contains no specific study results.
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